European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Trans-impedance matrix heatmap patterns in cochlear implant patients with different cochlear pathologies: meningitis, otosclerosis, and temporal bone fractures.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Alrushaydan Dalal, Alsufyani Atheer A, Alhussainan Khaled, Almuhawas Fida, Aljabr Mada, Yalcouy Hassan, Alsanosi Abdulrahman
Аннотация
PURPOSE: Transimpedance matrix (TIM) imaging is an electrical field-based modality that visualizes intracochlear current spread and may detect electrode malposition and subtle cochlear pathology beyond radiological resolution. This study aimed to evaluate etiology-specific TIM heatmap patterns in adult cochlear implant recipients and to assess the utility of TIM as an adjunct to conventional imaging.
METHODS: This observational retrospective case series included 11 adult cochlear implant recipients (15 implanted ears) with defined etiologies: head trauma/temporal bone fracture (5 ears), post-meningitis deafness (5 ears), and cochlear ossification or otosclerosis (5 ears). Preoperative CT and/or MRI confirmed pathology, and postoperative X-ray verified electrode position. TIM measurements were obtained using Cochlear® CustomSound EP software. A normal TIM pattern was defined as a continuous diagonal gradient from bottom-left to top-right. Deviations from this pattern were analyzed and correlated with etiology and radiological findings.
RESULTS: Distinct etiology-related TIM deviations were identified. Trauma cases showed off-diagonal irregularities and signal dissociation suggestive of fractures or over-insertion, including one abnormal TIM with normal imaging. Post-meningitis ears commonly demonstrated off-diagonal signal loss or apical attenuation without radiological correlations. Severe ossification with under-insertion produced an Ocean Pattern of low potentials, whereas one otosclerosis case preserved a normal diagonal pattern configuration.
CONCLUSION: TIM imaging is highly sensitive to changes in tissue conductivity and electrode-tissue interface integrity, enabling detection of early fibrosis or ossification not visible on standard imaging. TIM may serve as a useful adjunct in postoperative cochlear implant evaluation. Further prospective validation is required.
METHODS: This observational retrospective case series included 11 adult cochlear implant recipients (15 implanted ears) with defined etiologies: head trauma/temporal bone fracture (5 ears), post-meningitis deafness (5 ears), and cochlear ossification or otosclerosis (5 ears). Preoperative CT and/or MRI confirmed pathology, and postoperative X-ray verified electrode position. TIM measurements were obtained using Cochlear® CustomSound EP software. A normal TIM pattern was defined as a continuous diagonal gradient from bottom-left to top-right. Deviations from this pattern were analyzed and correlated with etiology and radiological findings.
RESULTS: Distinct etiology-related TIM deviations were identified. Trauma cases showed off-diagonal irregularities and signal dissociation suggestive of fractures or over-insertion, including one abnormal TIM with normal imaging. Post-meningitis ears commonly demonstrated off-diagonal signal loss or apical attenuation without radiological correlations. Severe ossification with under-insertion produced an Ocean Pattern of low potentials, whereas one otosclerosis case preserved a normal diagonal pattern configuration.
CONCLUSION: TIM imaging is highly sensitive to changes in tissue conductivity and electrode-tissue interface integrity, enabling detection of early fibrosis or ossification not visible on standard imaging. TIM may serve as a useful adjunct in postoperative cochlear implant evaluation. Further prospective validation is required.